Biomaterials: so many choices, so little time. What are the differences?

The use of biologic mesh has increased greatly in recent years in response to the need for a solution in managing contaminated hernias. Multiple different meshes are commercially available, and are derived from a variety of sources, including human dermis as well as animal sources. For a mesh to be effective, it must be resistant to infection, have adequate tensile strength for hernia repair, and be well tolerated by the host. To achieve this end, biologic meshes go through an intense processing that varies from one product to the next. In this article, the authors review the types of mesh available, how they are processed, and examine these characteristics in terms of their strengths and weaknesses in application to surgical technique.

Projective clustering using neural networks with adaptive delay and signal transmission loss.

We develop a new neural network architecture for projective clustering of data sets that incorporates adaptive transmission delays and signal transmission information loss. The resultant selective output signaling mechanism does not require the addition of multiple hidden layers but instead is based on the assumption that the signal transmission velocity between input processing neurons and clustering neurons is proportional to the similarity between the input pattern and the feature vector (the top-down weights) of the clustering neuron. The mathematical model governing the evolution of the signal transmission delay, the short-term memory traces, and the long-term memory traces represents a new class of large-scale delay differential equations where the evolution of the delay is described by a nonlinear differential equation involving the similarity measure already noted. We give a complete description of the computational performance of the network for a wide range of parameter values.

Frequency domain analysis of human subdural recordings.

SUMMARY: It is possible to localize many aspects of cortical function and dysfunction without the use of direct electrical stimulation of cortex. This study explores the degree to which information can be obtained about functional cortical organization relative to epileptogenic regions through analysis of electrocorticographic recordings in the frequency domain. Information about the extent of seizure regions and the location of the normal sensory and motor homunculus and some higher language and memory related areas can be obtained through the analysis of task-related power spectrum changes and changes in lateral interelectrode coherence patterns calculated from interictal and ictal recordings.

Mutually suppressive interrelations of symmetric epileptic foci in bitemporal epilepsy and their inhibitory stimulation.

OBJECTIVES: The goal of this study is to analyze the suppressive interaction of symmetric temporal lobe epileptic foci, assess some failures of epilepsy surgery, and evaluate the possibility of terminating focal seizures with stimulation of symmetric epileptic foci. MATERIALS AND METHODS: One hundred and twenty-nine intractable epilepsy patients (age range 6-53 years) with bitemporal epileptiform abnormalities in multiple scalp EEGs were evaluated with chronically implanted depth and subdural electrodes. Interelectrode coherence and power spectra were studied using internally developed software. RESULTS: Bitemporal epileptic foci were found in 85/129 (66%) patients with reciprocal relations between these foci in 57/85 (67%) patients. Temporal lobectomy was performed for 67/85 patients. 12/67 patients became free of seizures (Engel's Class I), 32/67 improved (Classes II and III), and 23/67 did not improve. 14/23 patients demonstrated post-surgical activation of the contralateral temporal lobe epileptic focus. For 8/14 of these patients, the stereotactic cryoamygdalatomy was performed in the temporal lobe contralateral to the first surgery. 5/8 patients became free of seizures. It was found that stimulation of temporal lobe deep epileptic focus may terminate focal seizures in the contralateral symmetric structures. CONCLUSION: A mutually suppressive relationship is one of variants of the interaction of symmetric epileptic foci. Some epilepsy surgery failures may be a result of post-surgical activation of the intact focus. The increase of coherence between both temporal lobes before the seizure onset of the seizure suggests the establishment of functional interrelations between two epileptic foci at an early, "hidden" phase of seizures, and may predict the direction of seizure spread. Mutually suppressive interrelations of symmetric epileptic foci might be employed for chronic therapeutic stimulation.

Locating chronically implanted subdural electrodes using surface reconstruction.

OBJECTIVE: To determine the accuracy of locating subdural electrodes by means of 3-D surface rendering of CT scans. METHODS: Open source software has been developed and posted on the web which segments the electrodes into 3-D surfaces and allows their 3-D locations to be exported to other EEG analysis programs. The accuracy of the technique was determined by studying 410 subdural electrodes implanted in four epilepsy patients. Accuracy was determined by comparing the locations from the rendering analysis to the locations of the same electrodes determined by conventional analysis of their appearance on individual CT slices. RESULTS: The average accuracy of a study of 410 electrodes imaged in four patients repeated two times by three observers was 0.91 (+/- 0.41) mm, with a maximum error of 3.3 mm, about half of the diameter of an electrode. CONCLUSIONS: The location of subdural electrodes can easily and quickly be determined within high-resolution CT scans through the use of 3-D rendering. SIGNIFICANCE: This relatively fast and easy method for determining the location of subdural electrodes should facilitate their use in both clinical and research investigations.

Amplitude and frequency dependence of spike timing: implications for dynamic regulation.

The spike-time reliability of motoneurons in the Aplysia buccal motor ganglion was studied as a function of the frequency content and the relative amplitude of the fluctuations in the neuronal input, calculated as the coefficient of variation (CV). Measurements of spike-time reliability to sinusoidal and aperiodic inputs, as well as simulations of a noisy leaky integrate-and-fire neuron stimulated by spike trains drawn from a periodically modulated process, demonstrate that there are three qualitatively different CV-dependent mechanisms that determine reliability: noise-dominated (CV < 0.05 for Aplysia motoneurons) where spike timing is unreliable regardless of frequency content; resonance-dominated (CV approximately 0.05-0.25) where reliability is reduced by removal of input frequencies equal to motoneuron firing rate; and amplitude-dominated (CV >0.35) where reliability depends on input frequencies greater than motoneuron firing rate. In the resonance-dominated regime, changes in the activity of the presynaptic inhibitory interneuron B4/5 alter motoneuron spike-time reliability. The increases or decreases in reliability occur coincident with small changes in motoneuron spiking rate due to changes in interneuron activity. Injection of a hyperpolarizing current into the motoneuron reproduces the interneuron-induced changes in reliability. The rate-dependent changes in reliability can be understood from the phase-locking properties of regularly spiking motoneurons to periodic inputs. Our observations demonstrate that the ability of a neuron to support a spike-time code can be actively controlled by varying the properties of the neuron and its input.